Digital radiography versus conventional radiography during excretory urography: our experience

The authors describe a computed radiographic system employed to generate and archive digital images in intravenous urography. For each exposure the system produces two digital images: the first (left image) simulates a conventional screen-film radiograph, the second (right image); enhances some spatial frequencies and emphasizes the margins of the structures. These images can be modified in their chief parameters and then printed by a laser-printer and archived on optical disks. Four experienced radiologists evaluated digital images with regard to some chief diagnostic parameters and, in 50 patients, they compared digital images with conventional screen-film radiographs and submitted the results to statistical analysis. For some of the chosen parameters, particularly for the evaluation of renal margins before and after contrast medium injection, digital images gave statistically better results than conventional films, while, no statistically significant different was observed for the other parameters. From the results of this preliminary study digital radiography was found to be useful in intravenous urography by reducing the patient's exposition dose, by always obtaining images of good quality, and by enhancing some particular features of the standard image; on the other hand there were many unsolved problems regarding the communicating and archiving system (PACS), because of the slowness of the image transfer procedure, difficulties in data transmission and complexity of referential procedures.